On March 30, 2020, PUTT issued a formal letter including a 4-Point Plan to all state Boards of Pharmacy (BOP), Insurance Commissioners, and Governors in an effort to engage the use of independent pharmacies to combat COVID-19. The plan was simple, straightforward, and would allow pharmacies to relieve pressure on hospital systems while ensuring independent pharmacies remained solvent throughout the crisis.
PUTT heard back from a handful of states:
The Idaho, Kentucky, and Pennsylvania Boards of Pharmacy responded by thanking us for our suggestions and, in some cases, including additional helpful information while also deferring to their Departments of Insurance and/or Governors' offices. Minnesota's BOP Executive Director took the time to email a more detailed response of the state's efforts in our noted areas of concern both prior to, and during the COVID-19 crisis and included a PDF of documentation for reference going forward.
New Mexico's BOP response was unique in that not only did their Executive Director take the time to respond via email, she also immediately reached out to the state's independent pharmacy group requesting detailed information in the 4-Point Plan areas to determine next steps. Maine's BOP informed us that our plan has been added to their May meeting agenda. We will update members on the outcome of the meeting.
Arkansas, Ohio, Texas, and Kentucky Departments of Insurance responded via email with links to executive orders that have been issued regarding pharmacies' expanded roles during the COVID-19 crisis. Virginia's DOI penned a letter outlining (at the time) upcoming legislation that would rein in PBMs in the areas of licensure, audits, fees, and reimbursements. That legislation was subsequently signed by the Governor a week later.
The state of Washington's DOI sent the most impressive response to date. Their Deputy Insurance Commissioner's comprehensive 4-page letter addressed each of our points individually with regards to the state's emergency efforts and legislation - both in effect and upcoming - in each area. Disappointingly, Connecticut's DOI while acknowledging our communication, provided a "that's not in our jurisdiction" statement.
PUTT appreciates responding states' time and attention to our request amidst COVID-19. While responses were a mixed bag, any response is preferable to no response.
COVID-19 has exposed vulnerabilities in our country's healthcare system and is providing a unique opportunity to shine the light on how PBMs exploit the system for their own gain. Our 50-state outreach is only the beginning of our efforts. Even with a global pandemic occupying the country's thoughts, PUTT will continue to push for PBM reform.
Paraphrasing the immortal words of John Paul Jones, "(We) intend to go in harm's way ... Surrender? (We) have not yet begun to fight!"